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输尿管支架管在肾结核治疗中的应用
韩宇,许勇,符伟军,张磊,高江平,洪宝发
0
(解放军总医院泌尿外科,北京 100853)
摘要:
目的:探讨输尿管支架管(双“J”管)在肾结核治疗过程中,对于提高抗结核药治疗效果、保留患肾结构和功能的临床意义。方法:34例肾结核(22例合并单侧肾积水)患者随机分为2组,A组进行单纯抗结核药物治疗,B组在药物治疗前在患肾侧置入输尿管支架管(双“J”管)。抗结核药物治疗3个月后随访、复查。结果:治疗前两组尿常规、B超、静脉尿路造影(IVU)、CT和核素肾图检查结果无统计学差异,药物治疗3个月后随访显示两组间尿常规检查、红细胞沉降率异常、尿抗酸杆菌阳性率无统计学差异,而B超、CT检查、IVU和核素肾图结果差异具有统计学意义(P<0.05)。共21例患者行肾切除手术,A组15例(88.2%),B组6例(35.3%),具有统计学差异(P<0.05)。结论:肾结核药物治疗前在患肾侧置入输尿管支架管更有利于保留患肾的结构和功能,能降低患肾手术切除率。
关键词:  输尿管支架管  肾结核  治疗应用
DOI:10.3724/SP.J.1008.2008.00535
投稿时间:2008-02-28修订日期:2008-03-23
基金项目:
Application of double-J catheter in treatment of renal tuberculosis
HAN Yu,XU Yong,FU Wei-jun,ZHANG Lei,GAO Jiang-ping,HONG Bao-fa
(Department of Urological Surgery, General Hospital of PLA, Beijing 100853, China)
Abstract:
Objective:To investigate the therapeutic efficacy of double-J catheter in treatment of renal tuberculosis(TB) and in rescuing the structure and function of the kidney. Methods: Thirty-four patients with renal TB (22 combined with single side hydronephrosis) were divided into 2 groups randomly. Group A were treated with antituberculous therapy and group B with antituberculous therapy combined with pre-treatment with double-J catheter. All 34 patients were followed up for 3 months and were re-examined. Results: The results of B ultrasound, intravenous urogram (IVU), CT and isotope nephrogram were comparable between the 2 groups before treatment, and the results were significantly different between the two groups after 3 months’ drug treatment (P<0. 05). The results of routine urine tests, ESR and the positive rates of urine ABF were not significantly different between the 2 groups (P<0. 05). Nephrectomy was performed in 21 cases, with 15 cases(88.2%) in group A and 6 cases(35.3%)in group B (P<0. 05). Conclusion: Pre-treatment with double-J catheter in the diseased side of patients with renal TB can better preserve the structure and function of the kidney, and can help to lower the rate of nephrectomy.
Key words:  double-J catheter  renal tuberculosis  therapeutic uses